The Effectiveness of Immersive Virtual Reality-Based Treatment for Mental Disorders: A Systematic Review With Meta-Analysis

IF 5.3 2区医学 Q1 PSYCHIATRY

Acta Psychiatrica Scandinavica Pub Date : 2024-12-22 DOI:10.1111/acps.13777

Fatime Zeka, Lars Clemmensen, Lucia Valmaggia, Wim Veling, Carsten Hjorthøj, Louise Birkedal Glenthøj

{"title":"The Effectiveness of Immersive Virtual Reality-Based Treatment for Mental Disorders: A Systematic Review With Meta-Analysis","authors":"Fatime Zeka, Lars Clemmensen, Lucia Valmaggia, Wim Veling, Carsten Hjorthøj, Louise Birkedal Glenthøj","doi":"10.1111/acps.13777","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>The increasing number of studies of immersive virtual reality (VR) interventions for mental disorders call for an examination of the current level of evidence on their effectiveness. The findings may guide scalability and contribute to the advancement and optimization of immersive VR-based interventions for mental disorders.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>A systematic literature search across four databases screened 2443 studies. Outcomes were disorder-specific symptoms, cognition, function, and quality of life. The study is registered on PROSPERO (CRD42023465845) and follows the reporting standards outlined in the PRISMA guidelines.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Fifty-five studies involving a total of 3031 participants covering 10 mental disorders were included in the analysis. VR interventions demonstrated statistically significant effects of post-treatment compared to active control conditions for alcohol use disorder (reduced state anxiety, <i>g</i> = 0.89, 95% CI[0.24, 1.55]) and schizophrenia spectrum disorders (reduced psychotic symptoms, <i>g</i> = 0.37, 95% CI[0.04, 0.70]). Compared to passive control conditions, statistically significant effects of VR interventions were observed for panic and agoraphobia (<i>g</i> = 1.28, 95% CI [0.47, 2.10]), social anxiety disorder (<i>g</i> = 0.83, 95% CI [0.49, 1.17]), specific phobias (<i>g</i> = 1.07, 95% CI[0.22, 1.92]), depression symptoms in PTSD (<i>g</i> = 0.67, 95% CI [0.22;1.13]). In contrast, no significant differences were found between VR interventions and active control conditions for functioning and quality of life in schizophrenia spectrum disorder and panic or agoraphobia. No meta-analyses were conducted on cognition due to insufficient data. Over 50% of the included studies were assessed as having a high risk of bias. According to the GRADE assessment, evidence for VR-based interventions across various mental disorders was generally of low to very low certainty, with a few exceptions rated as moderate certainty.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>VR interventions may potentially have benefits, particularly when compared to passive control conditions, however, the evidence remains uncertain necessitating more large-scale, methodologically robust studies. Current findings can thus only be considered indicative. Recommendations on future directions of the VR field are discussed.</p>\n </section>\n </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"151 3","pages":"210-230"},"PeriodicalIF":5.3000,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta Psychiatrica Scandinavica","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/acps.13777","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}

引用次数: 0

Abstract

Background

The increasing number of studies of immersive virtual reality (VR) interventions for mental disorders call for an examination of the current level of evidence on their effectiveness. The findings may guide scalability and contribute to the advancement and optimization of immersive VR-based interventions for mental disorders.

Methods

A systematic literature search across four databases screened 2443 studies. Outcomes were disorder-specific symptoms, cognition, function, and quality of life. The study is registered on PROSPERO (CRD42023465845) and follows the reporting standards outlined in the PRISMA guidelines.

Results

Fifty-five studies involving a total of 3031 participants covering 10 mental disorders were included in the analysis. VR interventions demonstrated statistically significant effects of post-treatment compared to active control conditions for alcohol use disorder (reduced state anxiety, g = 0.89, 95% CI[0.24, 1.55]) and schizophrenia spectrum disorders (reduced psychotic symptoms, g = 0.37, 95% CI[0.04, 0.70]). Compared to passive control conditions, statistically significant effects of VR interventions were observed for panic and agoraphobia (g = 1.28, 95% CI [0.47, 2.10]), social anxiety disorder (g = 0.83, 95% CI [0.49, 1.17]), specific phobias (g = 1.07, 95% CI[0.22, 1.92]), depression symptoms in PTSD (g = 0.67, 95% CI [0.22;1.13]). In contrast, no significant differences were found between VR interventions and active control conditions for functioning and quality of life in schizophrenia spectrum disorder and panic or agoraphobia. No meta-analyses were conducted on cognition due to insufficient data. Over 50% of the included studies were assessed as having a high risk of bias. According to the GRADE assessment, evidence for VR-based interventions across various mental disorders was generally of low to very low certainty, with a few exceptions rated as moderate certainty.

Conclusion

VR interventions may potentially have benefits, particularly when compared to passive control conditions, however, the evidence remains uncertain necessitating more large-scale, methodologically robust studies. Current findings can thus only be considered indicative. Recommendations on future directions of the VR field are discussed.

查看原文本刊更多论文

沉浸式虚拟现实治疗精神障碍的有效性：荟萃分析的系统回顾。

背景：越来越多的沉浸式虚拟现实（VR）干预精神障碍的研究要求对其有效性的当前证据水平进行检查。这些发现可能会指导可扩展性，并有助于推进和优化基于沉浸式vr的精神障碍干预措施。方法：对4个数据库进行系统文献检索，筛选出2443项研究。结果是疾病特异性症状、认知、功能和生活质量。该研究已在PROSPERO注册（CRD42023465845），并遵循PRISMA指南中概述的报告标准。结果：55项研究共涉及3031名参与者，涵盖10种精神障碍被纳入分析。与主动对照组相比，VR干预对酒精使用障碍（减少焦虑状态，g = 0.89, 95% CI[0.24, 1.55]）和精神分裂症谱系障碍（减少精神病症状，g = 0.37, 95% CI[0.04, 0.70]）的治疗后效果具有统计学意义。与被动对照相比，虚拟现实干预对惊恐和广场恐怖症（g = 1.28, 95% CI[0.47, 2.10]）、社交焦虑障碍（g = 0.83, 95% CI[0.49, 1.17]）、特定恐惧症（g = 1.07, 95% CI[0.22, 1.92]）、PTSD抑郁症状（g = 0.67, 95% CI[0.22, 1.13]）的影响具有统计学意义。相比之下，在精神分裂症谱系障碍和恐慌或广场恐怖症的功能和生活质量方面，VR干预与主动控制条件之间没有显着差异。由于数据不足，未对认知进行meta分析。超过50%的纳入研究被评估为具有高偏倚风险。根据GRADE评估，基于vr的各种精神障碍干预措施的证据通常是低到极低的确定性，只有少数例外被评为中等确定性。结论：虚拟现实干预可能有潜在的益处，特别是与被动控制条件相比，然而，证据仍然不确定，需要更大规模的、方法学上可靠的研究。因此，目前的调查结果只能被认为是指示性的。讨论了虚拟现实领域未来发展方向。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Acta Psychiatrica Scandinavica 医学-精神病学

CiteScore

11.20

自引率

3.00%

发文量

135

审稿时长

6-12 weeks

期刊介绍： Acta Psychiatrica Scandinavica acts as an international forum for the dissemination of information advancing the science and practice of psychiatry. In particular we focus on communicating frontline research to clinical psychiatrists and psychiatric researchers. Acta Psychiatrica Scandinavica has traditionally been and remains a journal focusing predominantly on clinical psychiatry, but translational psychiatry is a topic of growing importance to our readers. Therefore, the journal welcomes submission of manuscripts based on both clinical- and more translational (e.g. preclinical and epidemiological) research. When preparing manuscripts based on translational studies for submission to Acta Psychiatrica Scandinavica, the authors should place emphasis on the clinical significance of the research question and the findings. Manuscripts based solely on preclinical research (e.g. animal models) are normally not considered for publication in the Journal.